Provider Demographics
NPI:1528560885
Name:CZYBORA, SANDRA M (MA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:CZYBORA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 SERPENTINE LN
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1646
Mailing Address - Country:US
Mailing Address - Phone:631-576-7875
Mailing Address - Fax:
Practice Address - Street 1:179 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6672
Practice Address - Country:US
Practice Address - Phone:347-705-0406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor